My Mom (93) had a stroke 6 weeks ago and is getting violent. Has anyone encountered this behavior? - AgingCare.com

My Mom (93) had a stroke 6 weeks ago and is getting violent. Has anyone encountered this behavior?

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She has no paralysis. She is getting increasingly more violent, trying to bite my Dad, me, nurses. Twists Dad's fingers until they bruise, slapping me. Very agitated - balling up sheets, ripping off her clothes. She is on hospice and they have started Ativan .5 mg twice a day, but SNF is reluctant to give it. This is so hard on my Dad (95 y.o.), he is still very alert, active, drives, etc. I would like to know if this is common with stroke patients and any suggestions? Thanks!

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My dad was in a facility when he went on hospice and the instructions were that he was to have Ativan PRN. And like what you've experienced, the nursing home was reluctant to give it at all. I tried to handle it myself with no success. I finally told hospice and they amended the orders to Ativan every 2 hours. No "as needed" attached. They bypassed the nursing home and had their own Dr. rewrite the orders.
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Thank you all for your suggestions. We do not have hospice "facilities" per se in this area. Hospice is an overlay service added to SNF. At this point, she is now quiet and comfortable and in the "active phase" of dying. We don't expect her to last more than a few days.
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I am right there with pamstegman...better advice you could not find.
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Well, that leaves a couple things - something does hurt and she won't admit it or can't pin it down, OR she is angry and frustrated about being unable to communicate. My mo would say "no" to anything hurting, because at that very moment with her not moving or doing anything it didn't, but of ocourse it was why she could not move or do anything. They finally put her on regular, not PRN Tylenol and that worked pretty well. Speech therapy helped my mom a bunch with that - it did not make the aphasia go away, but it made it a little better, gave her a little awareness of it and allowed her to compensate, though inconsistently. Her vision was too bad for a picture board to work. There could be something she wants that she can't ask for - maybe going outside? maybe a different food? The guessing games are really hard, and when we had to guess what my mom wanted (she'd often say one thing but get very angry when we did that, and it wasn't what she really meant) it could be very stressful because her limited insight made her think we were all just a bunch of dolts for not understanding her and we;d be getting yelled at the whole time...not a happy memory to bring back. This really is a tough situation, and I hope something works for it!
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Oy, thanks Pam. I should not email at red lights. Consult with a geriatric psychiatrist if you can!
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babalou means ATIVAN, I think auto spell got her again.
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In some elders, African can cause agitation
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She has had UTIs, and is currently on antibiotics for a recent one about a week ago but we have seen no improvement in her mental state now, as it has cleared up.
She does not appear to be in pain and has said no when ask in the past. Yes, it was 2 large (bilateral) strokes, that have severely affected her verbal abilities and cognition. We understand her confusion & problems communicating but are having a tough time experiencing these violent out bursts. They are now giving her the Ativan twice a day but we have not seen any improvement in the lat 2 days. Time to go back to hospice and ask them to re-evaluate her dosage.
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Yeah, this does not sound right. Something hurts her and/or she's got an infection and I take it the stroke was a bad one and she can't communicate verbally?
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Would it be possible she has a UTI? I remember reading here that a UTI in an elderly person can cause all types of different and strange behavior, even violence.
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